Demand Notice Form

DEMAND FOR STOP PAYMENT NOTICE

(Individual as Owner)

Name of owner:

Street Address:

City, State and Zip Code:

Name of direct contractor:

Street Address:

City, State and Zip Code:

Name of construction lender:

Street Address:

City, State and Zip Code:

Site of the Improvement:

Street Address:

City, State and Zip Code:

Legal Description:

Date:

COMES NOW, , as the owner of the real property undergoing improvements at the above location and demands that , a potential lien claimant (hereinafter “claimant”) who has furnished labor, services, equipment and/or materials for the work of improvements to the property above, provide the undersigned a Stop Payment Notice. The Stop Payment Notice should include the amount in value of the whole agreed to be done or furnished by the claimant; the amount in value of that already done or furnished; the amount the claimant has been paid; and the amount that remains due and unpaid.

If you fail to serve a Stop Payment Notice after this written demand, you will forfeit your right to a mechanic's lien.

Date:

PROOF OF NOTICE DECLARATION

(Civil Code § 8118)

I, , declare that I have served copies of the DEMAND FOR STOP PAYMENT NOTICE by (check appropriate box below):

a. By personally delivering copies to:

Name:

Title:

At: (Street Address)

City, State and Zip Code:

On: , 20 , at am / pm.

[Provide the above information for all other parties personally served on attached Exhibit A]

b. By Certified, Express, or Registered Mail Service, postage prepaid addressed to:

Name:

Title:

At: Street Address:

City, State and Zip Code:

On: , 20 , at am / pm.

[Provide the above information for all other parties served by mail / express service on attached Exhibit A]

See attached documentation provided by the US Postal Service or express mail service showing the date of delivery and the name of the person accepting delivery; tracking record or other documentation from express carrier showing attempted delivery or delivery of the notice; or, in the event of non-delivery, the returned envelope itself.

I declare under penalty of perjury that the foregoing is true and correct.

Signed at , California, on , 20 .

A notary public or other officer completing the certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of California

County of

On before me, (here insert name and title of the officer), personally appeared , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

Witness my hand and official seal.

Signature

(Seal)